title: Acute combined central and peripheral nervous system demyelination in children.
abstract: Reports of acute combined central and peripheral nervous system acquired inflammatory demyelination are rare in children. This study aimed to (1) define the clinical features and prognoses of patients with this entity; and (2) compare these patients with children presenting isolated acute central or peripheral nervous system demyelination. A retrospective chart review of 523 children with central or peripheral nervous system demyelination hospitalized between 1993-2006 was undertaken. Among these, 93 fulfilled criteria (clinical features and positive magnetic resonance imaging or electromyography/nerve conduction studies) for either acute central (n = 37; 39.8%) or peripheral (n = 43; 46%) nervous system demyelination, or a combination of the two (n = 13; 14%). Significant differences between groups were evident for age (median, 10 versus 7 versus 11 years, respectively; P = 0.047), admission to pediatric intensive care unit (8% versus 30% versus 58%, respectively; P = 0.001), length of hospital stay (median, 8 versus 9 versus 29 days, respectively; P < 0.001), treatment with steroids (52% versus 7% versus 75%, respectively; P < 0.001) and immunoglobulins (11% versus 81% versus 75%, respectively; P < 0.001), and poor evolution (3% versus 12% versus 54%, respectively; P = 0.002). This entity in children is not rare, and has a poorer outcome than isolated central or peripheral nervous system demyelination. Assessment is needed for a better understanding of risk factors, etiologies, management, and prognosis.
authors.affiliation: Department of Paediatrics, Sainte-Justine Hospital, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Tanja
authors.initials: T
authors.lastname: Adamovic
authors.forename: Emilie M
authors.initials: EM
authors.lastname: Riou
authors.forename: Geneviève
authors.initials: G
authors.lastname: Bernard
authors.forename: Michel
authors.initials: M
authors.lastname: Vanasse
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Décarie
authors.forename: Chantal
authors.initials: C
authors.lastname: Poulin
authors.forename: France
authors.initials: F
authors.lastname: Gauvin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002493:Central Nervous System Diseases / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003711:Demyelinating Diseases / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors